Text message reminders do not improve hepatitis B vaccination rates in an Australian sexual health setting

J Am Med Inform Assoc. 2016 Apr;23(e1):e88-92. doi: 10.1093/jamia/ocv145. Epub 2015 Oct 24.


Objective: To evaluate the impact of text message reminders (short messaging service (SMS)) on hepatitis B virus (HBV) vaccination completion among high risk sexual health center attendees.

Materials and methods: In September 2008, Sydney Sexual Health Centre implemented an SMS reminder system. The authors assessed the impact of the reminder system on HBV vaccination rates among patients who initiated a course. The authors used a chi-square test and multivariate logistic regression to determine if SMS reminders were associated with second and third dose vaccine completion, compared with patients prior to the intervention.

Results: Of patients sent SMS reminders in 2009 (SMS group), 54% (130/241) received 2 doses and 24% (58/241) received 3 doses, compared to 56% (258/463) (P = 0.65) and 30% (141/463) (P = 0.07) in the pre-SMS group (2007), respectively. Findings did not change after adjusting for baseline characteristics significantly different between study groups. There were no significant differences in completion rates among people who injected drugs, HIV-negative gay and bisexual men (GBM), and HIV-positive GBM. Among sex workers, travelers, and people who reported sex overseas, second and third dose completion rates were significantly lower in the SMS group compared to the pre-SMS group. In the SMS group, 18% of those who only had one dose attended the clinic within 1-18 months and 30% of those who had 2 doses attended in 6-18 months, but vaccination was missed.

Discussion: SMS reminders did not increase second or third vaccine dose completion in this population.

Conclusion: Clinician prompts to reduce missed opportunities and multiple recall interventions may be needed to increase HBV vaccination completion in this high risk population.

Keywords: Hepatitis B vaccination; sexual health; short messaging service (SMS); text messaging; vaccination reminders.

MeSH terms

  • Adult
  • Female
  • Hepatitis B / prevention & control*
  • Hepatitis B Vaccines* / administration & dosage
  • Humans
  • Logistic Models
  • Male
  • New South Wales
  • Reminder Systems*
  • Text Messaging*
  • Vaccination / statistics & numerical data*
  • Young Adult


  • Hepatitis B Vaccines